Provider Demographics
NPI:1609198985
Name:ASKEW, LEESHA L
Entity Type:Individual
Prefix:
First Name:LEESHA
Middle Name:L
Last Name:ASKEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 CHIP RD
Mailing Address - Street 2:
Mailing Address - City:KAWKAWLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48631-9174
Mailing Address - Country:US
Mailing Address - Phone:989-415-6771
Mailing Address - Fax:
Practice Address - Street 1:1517 CHIP RD
Practice Address - Street 2:
Practice Address - City:KAWKAWLIN
Practice Address - State:MI
Practice Address - Zip Code:48631-9174
Practice Address - Country:US
Practice Address - Phone:989-415-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53024107511835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric